المؤلفون: Rodway, Alexander D., Harris, Jenny, Hanna, Lydia, Allan, Charlotte, Casal, Felipe Pazos, Giltinan, Ciara, Dehghan-Nayeri, Ali, Santos, Andre, Whyte, Martin B., Ntagiantas, Nikolaos, Walton, Ivan, Brown, Richard, Skene, Simon S., Pankhania, Ajay, Field, Benjamin C. T., Maytham, Gary D., Heiss, Christian

المصدر: Biomedicines; Jul2023, Vol. 11 Issue 7, p2034, 14p

مصطلحات موضوعية: COVID-19 pandemic, ANGIOPLASTY, ISCHEMIA, COVID-19, COHORT analysis, INTRAVASCULAR ultrasonography, LEG amputation

مصطلحات جغرافية: UNITED Kingdom

مستخلص: We evaluated the impact of COVID-19 restriction on the angioplasty service and outcome of chronic limb-threatening ischaemia (CLTI) patients undergoing lower-limb angioplasty in a UK secondary care setting. Consecutive patients were analysed retrospectively. Pre-COVID-19 (08/2018–02/2020), 106 CLTI patients (91% Fontaine 4; 60% diabetes mellitus) and during COVID-19 (03/2020–07/2021) 94 patients were treated (86% Fontaine 4; 66% diabetes mellitus). While the average monthly number of patients treated did not change, the proportion of day cases significantly increased (53% to 80%), and hospitalised patients decreased. Patients treated in ≤14/5 days after referral significantly increased to 64/63%. Kaplan–Meier survival analysis (30-day/1-year) showed that neither wound healing nor mortality were significantly changed during COVID-19. In day cases, 1-year but not 30-day major amputations significantly increased, and clinically driven target-lesion revascularisation decreased during COVID-19. One-year mortality was significantly worse in hospitalised compared to day cases (14% vs. 43%) at similar wound healing rates (83% vs. 84%). The most frequent known cause of death was infectious disease (64%), while cardiovascular (21%) was less frequent. Despite COVID-19 restrictions, a safe and effective angioplasty service was maintained while shortening waiting times. Very high mortality rates in hospitalised patients may indicate that CLTI patients need to be referred and treated more aggressively earlier. [ABSTRACT FROM AUTHOR]

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المؤلفون: Soflaei, Sara Saffar, Baktashian, Mojtaba, Hashemi, Seyed Mohammad, Ghazizadeh, Hamideh, Naserifar, Zeynab, Moohebati, Mohsen, Davari, Hafezeh, Saberi-Karimian, Maryam, Mansouri, Rooholah, Ebrahimi, Mahmoud, Esmaily, Habibollah, Salehi, Mansoor, Ferns, Gordon A., Pasdar, Alireza, Ghayour-Mobarhan, Majid

المصدر: Journal of Cardio-Thoracic Medicine; Jun2023, Vol. 11 Issue 2, p1159-1166, 8p

مصطلحات موضوعية: CYTOKINES, GROWTH factors, EVEROLIMUS, CORONARY angiography, CORONARY artery disease, ATHEROSCLEROTIC plaque, TRANSLUMINAL angioplasty, DRUG-eluting stents

مصطلحات جغرافية: UNITED Kingdom

مستخلص: Introduction: It has been shown that angioplasty and endovascular stent deployment, used after coronary revascularization, are associated with an inflammatory response. Inflammation has a key role in the complications of atherosclerotic plaque, coronary artery disease (CAD) and in-stent restenosis (ISR). The objectives of the present study was to investigate serum levels of 12 pro/anti-cytokines and growth factors and their relationship with restenosis. Methods: A total of 244 subjects were recruited in current study including unrelated patients who previously underwent coronary stent implantation (between 2014 and 2017) and were subsequently indicated for coronary angiography. According to angiography results patients were allocated into two groups: cases with stenosis more than 50% within the stent (N=79) and controls with stenosis less than 50% within the stent (N=165). Serum was separated by centrifuging the blood for 15 min at 1000 rpm. Serum cytokines levels including IL-1α, IL-1β, IL-2, IL-4, IL-6, IL-8, IL-10, TNF-α, IFN-γ, MCP-1, EGF, and VEGF were measured using an EV 3513 cytokine biochip array (Randox Laboratories, Crumlin, UK). Results: The mean age of the NISR and ISR groups were 62.47±9.2 and 59.49±8.48 years, respectively. The diabetes frequency was significantly higher in the ISR group (55.1%) compared with NISR group (30.9%) (p<0.001). There was no significant difference in levels of cytokines between the two groups (p>0.05). Conclusions: The results showed that serum levels of pro/anti-inflammatory cytokines and growth factors did not have a significant difference between NISR and ISR study groups. [ABSTRACT FROM AUTHOR]

: Copyright of Journal of Cardio-Thoracic Medicine is the property of Mashhad University of Medical Science and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

المؤلفون: Miller, C.¹ (AUTHOR), Frood, R.¹ (AUTHOR), See, T.C.² (AUTHOR), Hammond, C.J.¹ (AUTHOR) christopherhammond@nhs.net

المصدر: Clinical Radiology. Jun2019, Vol. 74 Issue 6, p429-434. 6p.

مصطلحات موضوعية: *INTERVENTIONAL radiology, *ANGIOPLASTY, *ILIUM, *ILIAC artery, *DISEASE complications, *THERAPEUTICS

مصطلحات جغرافية: UNITED Kingdom

مستخلص: Aim: To provide an update of current practice in iliac artery intervention in the UK.Materials and Methods: Ninety-nine interventional units across the UK completed online submission forms for iliac angioplasty and stent procedures between 2011 and 2014 (inclusive) for the British Iliac Angioplasty and Stenting (BIAS) IV registry.Results: Data for 8,294 procedures were submitted during the study period. A total of 12,253 iliac segments were treated in 10,311 legs. The commonest indication was claudication (n=5219, 64.4%). Of the cases performed, 6,582 (80.8%) were performed electively with 3,548 (44.8%) of the procedures performed as a day-case and 6,586 (54%) of the lesions were treated with stents. Successful endovascular intervention (residual stenosis ≤49%) was achieved in 11,847 (97%) of treated segments, with residual stenosis in 1.5%. One point five percent of lesions could not be crossed with a wire. Limb complications were recorded in 366 (3.5%), resulting in 141 patients undergoing an unplanned intervention and 173 (2.2%) patients had a systemic complication. There were 84 deaths prior to discharge, of which 13 (15%) were procedure related. Both systemic and limb complication rates were higher in patients undergoing treatment for critical ischaemia.Conclusion: Iliac stenting and angioplasty are associated with high technical success with a low complication rate. These data provide up-to-date statistics for patient information and future audit and benchmarking purposes. [ABSTRACT FROM AUTHOR]

المؤلفون: Cragg, James¹, Lowry, Danielle¹, Hopkins, Jonathan², Parker, David², Kay, Mark¹, Duddy, Martin², Tiwari, Alok¹ alok@doctors.org.uk

المصدر: Vascular & Endovascular Surgery. Feb2018, Vol. 52 Issue 2, p93-97. 5p.

مصطلحات موضوعية: *POPLITEAL artery, *ANGIOPLASTY, *ARTERIAL puncture, *BLOOD vessels, *DEMOGRAPHY, *FEMORAL artery, *HEMATOMA, *LONGITUDINAL method, *MEDICAL equipment, *PATIENT safety, *PERIPHERAL vascular diseases, *DATA analysis software, *TERTIARY care, *ANATOMY

مصطلحات جغرافية: UNITED Kingdom

مستخلص: Purpose: Previous reports have suggested higher periprocedural complications after ipsilateral antegrade femoral arterial access (AA). We looked at a contemporary series comparing complication rates between AA and contralateral retrograde femoral arterial access (RA) for femoropopliteal angioplasty. Method: A prospective review of all cases between 2010 and 2015 in a United Kingdom tertiary vascular center. Demographical and procedural data were obtained for those undergoing percutaneous femoropopliteal angioplasty. The primary outcome looked at periprocedural complications including retroperitoneal hematoma, pseudoaneurysm, hematoma requiring transfusion, arteriovenous fistulation, and surgical intervention. Secondary outcomes included contrast and radiation doses in addition to procedural failure leading to major amputation. Results: A total of 556 (66% male) patients underwent femoropopliteal angioplasty, 461 (82%) via AA. Groups were of comparable age, sex, comorbidity, and symptomatology. AA patients had a lower body mass index, 26 versus 29 (P = .005). No significant difference was seen in periprocedural (15.8% AA vs 11.6% RA; P = 0.292) or access site complications (3.7% AA vs 1.1% RA; P = 0.186). There was less need for a closure device, 40.3% AA vs 73% RA (P < .01), less contrast, 94 mL AA: 114 mL RA (P < .001), and less radiation, 3487 cGy cm2 AA: 9697 cGy cm2 RA (P < .001). Arterial access was also associated with greater technical success of 83.8%: 73.3% RA (P = .002). Conclusions: Arterial access is associated with higher technical success and reduced contrast/radiation doses with no significant difference in complications compared to RA contrary to previous reports. [ABSTRACT FROM AUTHOR]

المؤلفون: Iles‐Smith, Heather¹ heather@iles-smith.co.uk, Deaton, Christi², Campbell, Malcolm³, Mercer, Catherine^4,5, McGowan, Linda⁵

المصدر: Journal of Clinical Nursing (John Wiley & Sons, Inc.). Nov2017, Vol. 26 Issue 21-22, p3511-3518. 8p.

مصطلحات موضوعية: *ANGER, *ANGIOPLASTY, *ANXIETY, *MENTAL depression, *FEAR, *CARDIAC patients, *INTERVIEWING, *RESEARCH methodology, *MYOCARDIAL infarction, *RESEARCH funding, *UNCERTAINTY, *QUALITATIVE research, *JUDGMENT sampling, *DATA analysis, *THEMATIC analysis, *PATIENT readmissions, *PATIENTS' attitudes

مصطلحات جغرافية: UNITED Kingdom

مستخلص: Aims and objectives To explore the experiences of patients readmitted due to potential ischaemic heart disease symptoms within six months of primary percutaneous coronary intervention. Background Following myocardial infarction and primary percutaneous coronary intervention, some patients experience potential ischaemic heart disease symptoms that may lead to readmission. Symptoms may be related to cardiac ischaemia, reduced psychological health or a comorbid condition. Design A qualitative study involving semistructured, in-depth interviews conducted once, mean 196 (50-384) days following readmission (at least six months following original ST-elevation myocardial infarction and primary percutaneous coronary intervention). This is the qualitative part of a mixed methods study. Methods Participants were purposefully selected, and concurrent sampling, data collection and data analysis were performed. Data were organised using framework analysis; constant comparative analysis involving deduction and induction led to identification of cogent themes and subthemes. Results Twenty-five participants (14 men, 27-79 years) experienced 1-4 readmissions; discharge diagnoses were cardiac, psychological, indeterminate, pulmonary and gastric. Three main themes emerged: (1) anxiety, uncertainty and inability to determine cause of symptoms, (2) fear of experiencing further myocardial infarction and (3) insufficient opportunity to validate self-construction of illness. Conclusion Fear of dying or experiencing a further myocardial infarction led to patients seeking help at the time of potential ischaemic heart disease symptoms. Participants were anxious and lacked understanding regarding symptom attribution at the time of readmission and generally following their heart attack. Additionally, original heart attack symptoms were used as a comparator for future symptoms. Participants reported feeling well immediately after primary percutaneous coronary intervention but later experiencing fatigue and debilitation often linked to potential ischaemic heart disease symptoms. Relevance to clinical practice Increased education and information related to symptom attribution post-primary percutaneous coronary intervention and postreadmission are worthy of exploration and may lead to increased understanding and reassurance for this patient group. [ABSTRACT FROM AUTHOR]

المؤلفون: Jaffer, Ounali, Gibbs, Paul, Gibson, Matthew, Gilbert, James, Hanko, Jennifer, Jeevaratnam, Praveen, Jones, Robert, Nicholas, Johann, Ramnarine, Raymond, Sivaprakasam, Rajesh, Steiner, Kate, Tippett, Richard, Wilkins, Jason

المصدر: CardioVascular & Interventional Radiology; Nov2021, Vol. 44 Issue 11, p1736-1746, 11p

مصطلحات موضوعية: HEMODIALYSIS patients, TRANSLUMINAL angioplasty, STENOSIS, HEMODIALYSIS, SYMPTOMS

مصطلحات جغرافية: UNITED Kingdom

مستخلص: Purpose: Stenoses in mature arteriovenous fistulas (AVFs) are common and can negatively impact on the quality of haemodialysis, the longevity of the AVF and lead to debilitating symptoms. Multiple treatment options exist; however, management can vary between different centres. We aimed to establish multidisciplinary consensus on the optimal stepwise application of interventions based on evidence and consensus.Methods: A modified Delphi process was conducted with 13 participants from hospitals across the UK, all of whom have high-volume dialysis access practice.Results: The usual intervention to rectify de novo stenoses of mature AVFs is fistuloplasty, although surgery for inflow segment stenoses is also clinically acceptable. Appropriate first-line interventions include plain old balloon angioplasty or high-pressure balloon angioplasty; if these fail during the fistuloplasty, consider upsizing the balloon, prolonged balloon inflation or using alternative interventions, such as cutting or scoring balloons and ultra-high-pressure balloons. Alternative or subsequent interventions vary by anatomical site and may require additional multidisciplinary team input. For a stenoses recurring between 3 and 12 months, it is appropriate to consider interventions used de novo, but with a lower threshold for using drug-coated balloons (DCBs) in all regions and for using stent grafts in all regions but inflow segment. Recurrence after 12 months should be treated as a de novo lesion, with DCBs considered if they have been used successfully during previous interventions.Conclusions: These recommendations aim to provide a practical guide to multidisciplinary teams in order to optimise the use of multiple interventions for rectifying AVF stenoses and provide unified evidence-based practice guidelines. [ABSTRACT FROM AUTHOR]

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المؤلفون: Langdridge, Darren¹ darren.langdridge@open.ac.uk

المصدر: Qualitative Health Research. Jul2017, Vol. 27 Issue 9, p1391-1401. 11p.

مصطلحات موضوعية: *CONVALESCENCE, *ANGIOPLASTY, *ANXIETY, *AUTOBIOGRAPHY, *ELECTROCARDIOGRAPHY, *PSYCHOLOGY of cardiac patients, *MYOCARDIAL infarction, *PSYCHOTHERAPY, *ETHNOLOGY research, *PATIENT readmissions, *PSYCHOLOGY

مصطلحات جغرافية: UNITED Kingdom

مستخلص: In this article, I explore the experience of recovery from a heart attack through an analytic autoethnography. I discuss the tensions inherent in biomedical subjectivities of health and ill-health during cardiac recovery through three key themes: (a) the transfer of responsibility and becoming a subject “at risk,” (b) technologies of biomedicine and the disciplining of subjectivities, and (c) the transformation of a body toward a new pharmaceuticalized bodily normal. Through an analysis driven by the biomedicalization thesis of Clarke, alongside work on biopower and the governmentality of health by Foucault, Rose, and Rabinow, I seek to provide new insights into the process of cardiac recovery and the relationship between individual experience and broader socio-political processes. Key to this analysis is a focus on the contingent subjectivities brought into being through biomedicalization that constitute a new form of health citizenship that is otherwise not accounted for in narratives of recovery. [ABSTRACT FROM AUTHOR]

المؤلفون: Henderson, Robert A., Pocock, Stuart J., Sharp, Stephen J., Nanchahal, Kiran, Sculpher, Mark J., Buxton, Martin J, Hampton, John R.

المصدر: Lancet. 10/31/1998, Vol. 352 Issue 9138, p1419-1425. 7p. 1 Diagram, 3 Charts, 5 Graphs.

مصطلحات موضوعية: TRANSLUMINAL angioplasty, CORONARY artery bypass, MYOCARDIAL revascularization, CORONARY heart disease surgery, ANGINA pectoris treatment

مصطلحات جغرافية: UNITED Kingdom

مستخلص: Reports the clinical and cost results of a study to compare the long-term effects of percutaneous transluminal coronary angioplasty and coronary-artery bypass grafting among patients with angina in whom equivalent revascularization could be achieved by either treatment method. The Randomised Intervention Treatment of Angina trial (RITA-1) being a multicenter study of coronary heart disease patients in Great Britain; Methods; Findings; Interpretation.

المصدر: Journal of Health Services Research & Policy. Jan2016, Vol. 21 Issue 1, p43-50. 8p.

مصطلحات موضوعية: *ANGIOPLASTY, *ANTICOAGULANTS, *ATRIAL fibrillation, *COST effectiveness, *HEALTH services accessibility, *MEDICAL care, *MEDICAL personnel, *HEALTH policy, *MEDICAL protocols, *MEDICAL research, *MYOCARDIAL infarction, *PHARMACISTS, *PRIMARY health care, *THERAPEUTICS, *COMMUNITY-based social services

مصطلحات جغرافية: UNITED Kingdom

مستخلص: The article offers information on the Whole System Demonstrator (WSD) research programme which analyzes the role of technology in managing health and safety of people. It highlights the impact of WSD on Great Britain Department of Health's policy and strategies regarding use of tele-assistive devices to meet health care demands.

المؤلفون: Mathur, K.¹, Ayyappan, M. K.¹, Hodson, J.², Hopkins, J.³, Tiwari, A.¹, Duddy, M.³, Vohra, Rajiv¹ rajiv@vohra.org.uk

المصدر: Vascular & Endovascular Surgery. Apr/May2015, Vol. 49 Issue 3/4, p63-68. 6p.

مصطلحات موضوعية: *ANGIOPLASTY, *FISHER exact test, *ISCHEMIA, *LEG injuries, *LIMB salvage, *SURGICAL complications, *TREATMENT effectiveness, *RETROSPECTIVE studies, *DATA analysis software, *DESCRIPTIVE statistics, *KAPLAN-Meier estimator

مصطلحات جغرافية: UNITED Kingdom

مستخلص: Objectives: To study factors affecting patency and medium-term outcomes after crural angioplasty. Materials and Methods: All crural angioplasties between March 2003 and September 2010 were reviewed from a prospective database to analyze primary patency, amputation-free survival, and limb salvage. Results: Five hundred and twenty-seven limbs in 478 patients (58.7% male, mean age 73.9 ± 0.53 years) were treated. In all, 49.1% were diabetic patients and 7.4% were dialysis dependent. Primary patency was 65.5%, 57.8%, 48.5%, and 32.9% at 1, 6, 12, and 36 months, respectively. Amputation-free survival was 75.2% at 1 year and 59.0% at 3 years. Limb salvage at 3 years was 92.7%. Rutherford categories 5 and 6 had a consistent adverse effect on patency. This led to an adverse amputation-free survival and limb salvage at 3 years. Conclusion: Crural angioplasty is an effective treatment for limb salvage. Its outcomes are adversely affected by diabetes, renal disease, coronary disease, and worsening Rutherford grade. [ABSTRACT FROM AUTHOR]